Combined therapy effective in reducing urinary albumin creatinine ratio
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Key takeaways
- Combining SGLT2 inhibitors and mineralocorticoid receptor antagonists was effective in reducing urinary albumin creatinine ratio.
- The combined therapy was more effective than single therapies or placebo.
AUSTIN, Texas — Results presented here showed that combining SGLT2 inhibitors and mineralocorticoid receptor antagonists was effective in reducing the urinary albumin creatinine ratio in patients with type 2 diabetes.
The combined therapy was more effective than treating patients with SGLT2 inhibitors or mineralocorticoid receptor antagonists (MRAs) alone, or with placebo, Ryutaro Morita, MD, and colleagues wrote in a poster presentation at the National Kidney Foundation Spring Clinical Meetings.
“Diabetes mellitus (DM) is the leading cause of chronic kidney disease. Albuminuria is associated with an increased risk of cardiovascular mortality,” Morita, with the department of medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, and colleagues wrote. “[SGLT2 inhibitors] and [MRAs] are known to be protective against albuminuria, but the effects of the combination of these drugs remain unclear.
“We adopted a network meta-analysis to investigate the effects of SGLT2 [inhibitors], MRAs and their combination on albuminuria in type 2 [diabetes] with albuminuria.”
Researchers found 17 studies after a search of publications on PubMed, Medline, EMBASE and the Cochrane Library. “We selected randomized control trials (RCTs) or crossover trials that compared MRAs, SGLT2 [inhibitors], MRAs [and] SGLT2 [inhibitors] or placebo in type 2 diabetes patients with urinary albumin creatinine ratio (UACR) [of at least] 30 mg/g creatinine. The primary outcome was a change in UACR,” the authors wrote.
A review of the studies, which represented 34,412 patients, showed that “SGLT2 inhibitor combined with MRAs reduced albuminuria compared with SGLT2[inhibitors], MRAs and placebo,” the authors wrote. “Treatment with SGLT2[inhibitors] alone or MRAs alone also significantly reduced UACR compared to placebo. The effects of MRAs are comparable to that of SGLT2 [inhibitors]. Sensitivity analyses showed a similar tendency,” the authors wrote.
“The combination of SGLT2 [inhibitors] and MRAs more effectively reduces UACR in patients with type 2 [diabetes] and albuminuria compared with SGLT2 [inhibitors] alone, MRAs alone, or placebo,” Morita and the authors concluded.
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Morita R, et al. Poster #280. Presented at: National Kidney Foundation Spring Clinical Meetings; April 11-15, 2023; Austin, Texas.
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